Heart rate post surgery (especially during exercise)

[WXYZ1234]

I asked a question about 6 weeks ago on exercise post aortic valve/root/ascending aorta replacement surgery. The answers and feedback was immensely helpful and I was hoping to get a bit more insight as my recovery continues.

I am now 12 weeks post initial surgery (I was readmitted to hospital about 10 days post surgery for an additional two weeks due to both pericardial and plueural effusion, which involved additional surgery). Exercise is progresssing well - 6 times a week and I have moved on from walking to light jogging, up to about 4.5 miles (very slow compared to pre-surgery, but definite progress). I am also doing three strength and conditioning sessions a week (very light weights) so feeling like recovery is really now on track after the initial early setbacks.

The surgical team have removed any maximum heart rate restrictions and the one session I have had with the NHS cardiac rehab team, they said just to get on with life, run to feel for the next month and not to stress around the level the HR gets to.

I am finding that last bit easier said than done. My resting HR was around +30 bpm higher post surgery. That is carrying through to exercise - with the gap between pre-surgery and post surgery HR getting higher as my HR goes up (so during a run today it was around +50 bpm higher at the top end of the range than would have been the case pre-surgery). I am sure that the higher heart rate is in part due to the surgery and healing process, part down to me being less fit and part down to my anxiety when exercising.

Any thoughts and experiences of higher HR post surgery would be really appreciated.

[Coper10]

My AVR was March 2021. I missed out on cardiac rehab due to COVID but have recently had 8 sessions. Before having this, I was mainly doing very brisk walking alternating with short jogs (for about 3 minutes at a time) and trying to increase my distance jogging. When starting the rehab, I got a heart rate monitor. I explained my heart rate went to 156 when doing the jogging bits (I am 53) and was told that was a bit high. It was explained to me that my heart had to get used to working harder very gradually - so I could still do the intervals but reduce the time jogging so my heart rate didn’t get as high before reducing. That way it could get used to working harder without such a shock. As a result I now walk for a minute then jog for a minute. I will then gradually increase the time. This seems to be working as my heart rate now doesn’t get as high. I am speaking as someone who has never been a runner but was aiming to complete a Parkrun without walking! I have also heard of the Maffertone method re lower heart rate but haven’t looked into this.All the very best to you 🙂

[JulesP86]

Hi - that's great news that you feel like your fitness is on track so soon. You mentioned about your resting HR being higher pre-op, just wondering if you are on any medication now post op that you weren't on before? I had a valve replacement in 2017 and my new resting HR is around 54bmp. This is obviously affected when I exercise as it doesn't get as high as it used to due to the medication.

[WXYZ1234 in reply to JulesP86]

Thank you for taking the time to respond. My situation is the other way around to yours. Pre-op I was very active right up to before surgery and had a resting HR in the 40s and now it is in the 70s, with this post operative increase being even greater when I am exercising. I have read that the HR can/does take a bit of time to settle back down to find a new normal post operation, but there are not a huge number of data points on this (that I can find anyway). (No medication pre-surgery and post I am now down to just taking aspirin and omeprazole daily.)

[JulesP86 in reply to WXYZ1234]

Do you have a cardiologist or cardiac nurse that you could maybe ask for some advice?

[WXYZ1234 in reply to JulesP86]

I have asked the surgeon and the cardiac rehab (seeing the cardiologist next week). They have said things will settle down over time but other than that it is all very dependent on the individual (age, level of fitness before etc.). They were also reassuring about the level and intensity of exercise.

I suppose one of the things I have found difficult post operation is that there is far less information to guide you though it. Pre-op, you can research the type of operation, the type of valve and bore yourself rigid with statistics (if you choose to - and I did!!). Post op, I am finding the lack of solid data points tough - probably exacerbated due to some of the complications I subsequently had.

[aks07]

Hi, sounds like you are doing really well with your recovery - well done.

I experienced similar increase in heart rate post surgery (5xCABG in Sep 21) of between 20-30bpm in my resting heart rate, and like yourself couldn't seem to find my much data about this.

I've been monitoring my heart rate with my watch, and also returned to training using a heart rate chest strap monitor 3-4 times a week since early Dec, so around 12 weeks post surgery.

I'm now around 30 weeks post surgery and my resting heart rate is only very recently returning to pre-surgery levels, so I'm thinking it just takes time for the healing process and the heart to adjust but it gets there eventually?

Hope that helps.

[WXYZ1234 in reply to aks07]

Thank you. Really appreciate it.

[Newvalve]

Hey,

I know this post was a few years ago but wondering if you for any answers or if your exercising HR returned to pre surgery levels?

I had a mechanical aortic valve and root replacement 13 weeks ago. Back running 7km but my average HR is 15-20bpm higher than pre surgery levels and my pace is much slower.

Before I was diagnosed I ran marathon and done triathlons. I know I’ll never get back to the same level of fitness but I’m hoping to get back to running 10k comfortably and doing some HIIT classes.

Cheers

[WXYZ1234 in reply to Newvalve]

Hi there.

I am now three years post the surgery and various complications.

So I am doing cardio 6x a week (mostly running) plus 2-3 strength and conditioning sessions. All in if I think through how long it felt me to feel totally normal again (or find what was a new normal) it was probably 2 years - although I suspect some of that was in my head also.

The increased HR issue did settle down and my HR is close to back to where it was pre surgery. My resting is a little bit higher but also I don’t take my max quite as high as I used to (I am now 53 and used to get up to 165-167 at the top end of exercising but it’s more like 161 these days).

I have been out and done some long runs (I ran a sub 3 hour marathon the year before surgery) but my slow/long run pace is 30 seconds a km slower now. I have also lost my top end pace - so when doing hill or speed intervals my top pace is about 1.5kph slower than it was pre surgery. Not sure how much is aging, how much is the lungs not working as well due to the pleural effusion and how much because I am not pushing the top end quite as much as I used to.

The good news is, although I am not as fast I am really enjoying my running again and focusing on the fact it’s just great to be out there given all I went through. I also found an appreciation for the strength work and so am more focused on that than I used to be.

I hope this helps a bit and good luck with the recovery.

All the best.